Funding

Organisation Name*

Your Name*

Company and Charity no (if applicable)

Company: (*applications are accepted from organisations that operate for charitable, community or social purposes operating on a non profit basis)

Charity:

Office Address*








Postcode:

Name of contact person*

Job Title of contact person*

Daytime landline number

Mobile number

Email*

We have read and accept the Grant-Making Policy of the Charity* (found here)
YesNo

Title of project*

Brief description of project (maximum 400 words)*

Which areas of Teesside will your project benefit?*

Purpose of project (maximum 100 words)*

Please state how you believe the project will benefit the public/community*

Length of project*
years: months:

Expected start date*

Expected finish date*

How many people will benefit this project/funding?*

Amount of funding being requested from Charity*(please note: we will not fully fund a project)
(£)

Please provide a breakdown of requested funding:*

Will any of the funding be used to meet your organisation's
core operational costs/overheads?*
YesNo

If yes, how much
(£)

Total cost of project*
(£)

Please provide a detailed breakdown of the full project:*

Are you seeking a one-off payment?*
YesNo

If no, please provide further details

Please tick the following to indicate the charitable purpose(s) for which you seek funding:
Relief of needEnvironmentClubs and Activity Groups (excluding Sports) (includes Armed Forces, Emergency Services, Arts & Heritage)Sports Clubs and Sporting Activities (includes individual sports persons)Human rights and Community cohesionHealth and wellbeingEmployment and Training (including apprenticeships)

other(please specify):

Do you wish the grant to be paid directly to your organisation?*
YesNo

If no, to whom would you like the grant to be paid?

If successful, we will issue a BAC’s payment within 14-21 days.

Will your organisation obtain funding for the project from any other source?*
YesNo

If Yes, please list all other sources of funding and amounts being provided from each source?

If No, please state your reasons why?(please note: we will not fully fund a project)

Without the grant, would your organisation be able to carry out the project?*
YesNo

If yes, please explain your reasons for applying

If no, what is your contingency plan if unsuccessful from the charity?

Does your project or organisation involve working with young children and/or vulnerable adults?*
YesNo

If yes, please send your safeguarding policy within 24 hours to jenny.w@teessidecharity.org.uk

Have you received funding from The Teesside Charity in the past?
YesNo

If yes, please let us know the amount, date and reason for funding.

Does your organisation have adequate insurance in place to enable the project to be carried out in a safe and competent manner (this includes having insurance in place to cover the health and safety of anyone involved in the project)?*
YesNo

Does your organisation agree to comply with the terms and conditions contained in the Letter of Grant?* (found here)
YesNo

Will your organisation permit the trustees or representative to visit your organisation or the project for the purpose of monitoring the use of the grant? (please note: this will not be necessary in all cases)*
YesNo

Does your organisation agree to acknowledge the Charity and the grant in any publicity material relating to the project?*
YesNo

If required by the Charity, does your organisation agree to submit a report or reports demonstrating what progress has been made on the project? (In certain cases, future instalments of grant payments will only be made upon receipt of a satisfactory progress report)*
YesNo

For my application to be considered, I understand I must forward a copy of my most recent accounts to jenny.w@teessidecharity.org.uk*
YesNo

How did you hear about The Teesside Charity?

FOR RESEARCH GRANTS ONLY

Is your organisation fully authorised to carry out the research?
YesNo

Do you confirm that your organisation will comply with all relevant statutory legislation and other regulations in force in so far as they relate to the research?
YesNo

Has your organisation obtained all of the necessary consents and authorities required to carry out the research?
YesNo

How do you intend to publish the results of the research you carry out?

DECLARATION

I declare that the contents of this Application Form are true.

YesNo

Please note: We require a copy of your latest accounts and a full breakdown of how the funds will be spent. Please send these in a separate email to jenny.w@teessidecharity.org.uk within 24 hours of applying.